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Noma K, Tsumura M, Nguyen T, Asano T, Sakura F, Tamaura M, Imanaka Y, Mizoguchi Y, Karakawa S, Hayakawa S, Shoji T, Hosokawa J, Izawa K, Ling Y, Casanova JL, Puel A, Tangye SG, Ma CS, Ohara O, Okada S. Isolated Chronic Mucocutaneous Candidiasis due to a Novel Duplication Variant of IL17RC. J Clin Immunol 2023; 44:18. [PMID: 38129603 PMCID: PMC10807285 DOI: 10.1007/s10875-023-01601-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE Inborn errors of the IL-17A/F-responsive pathway lead to chronic mucocutaneous candidiasis (CMC) as a predominant clinical phenotype, without other significant clinical manifestations apart from mucocutaneous staphylococcal diseases. Among inborn errors affecting IL-17-dependent immunity, autosomal recessive (AR) IL-17RC deficiency is a rare disease with only three kindreds described to date. The lack of an in vitro functional evaluation system of IL17RC variants renders its diagnosis difficult. We sought to characterize a 7-year-old Japanese girl with CMC carrying a novel homozygous duplication variant of IL17RC and establish a simple in vitro system to evaluate the impact of this variant. METHODS Flow cytometry, qPCR, RNA-sequencing, and immunoblotting were conducted, and an IL17RC-knockout cell line was established for functional evaluation. RESULTS The patient presented with oral and mucocutaneous candidiasis without staphylococcal diseases since the age of 3 months. Genetic analysis showed that the novel duplication variant (Chr3: 9,971,476-9,971,606 dup (+131bp)) involving exon 13 of IL17RC results in a premature stop codon (p.D457Afs*16 or p.D457Afs*17). Our functional evaluation system revealed this duplication to be loss-of-function and enabled discrimination between loss-of-function and neutral IL17RC variants. The lack of response to IL-17A by the patient's SV40-immortalized fibroblasts was restored by introducing WT-IL17RC, suggesting that the genotype identified is responsible for her clinical phenotype. CONCLUSIONS The clinical and cellular phenotype of the current case of AR IL-17RC deficiency supports a previous report on this rare disorder. Our newly established evaluation system will be useful for the diagnosis of AR IL-17RC deficiency, providing accurate validation of unknown IL17RC variants.
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Affiliation(s)
- Kosuke Noma
- Department of Pediatrics, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Miyuki Tsumura
- Department of Pediatrics, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Tina Nguyen
- Immunology Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, NSW, Australia
| | - Takaki Asano
- Department of Pediatrics, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Fumiaki Sakura
- Department of Pediatrics, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Moe Tamaura
- Department of Pediatrics, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yusuke Imanaka
- Department of Pediatrics, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yoko Mizoguchi
- Department of Pediatrics, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Shuhei Karakawa
- Department of Pediatrics, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Seiichi Hayakawa
- Department of Pediatrics, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Takayo Shoji
- Division of Pediatric Infectious Diseases, Shizuoka Children's Hospital, Shizuoka, Japan
| | | | - Kazushi Izawa
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yun Ling
- Department of Infectious Disease, Shanghai Public Health Clinical Center, Shanghai, China
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris Cité, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
- Howard Hughes Medical Institute, New York, NY, USA
- Department of Pediatrics, Necker Hospital for Sick Children, Paris, France
| | - Anne Puel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris Cité, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Stuart G Tangye
- Immunology Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, NSW, Australia
| | - Cindy S Ma
- Immunology Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Kensington, NSW, Australia
| | - Osamu Ohara
- Kazusa DNA Research Institute, Kisarazu, Chiba, Japan
| | - Satoshi Okada
- Department of Pediatrics, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
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Noma K, Tsumura M, Nguyen T, Asano T, Sakura F, Tamaura M, Imanaka Y, Mizoguchi Y, Karakawa S, Hayakawa S, Shoji T, Hosokawa J, Izawa K, Ling Y, Casanova JL, Puel A, Tangye SG, Ma CS, Ohara O, Okada S. Isolated chronic mucocutaneous candidiasis due to a novel duplication variant of IL17RC. Res Sq 2023:rs.3.rs-3062583. [PMID: 37577484 PMCID: PMC10418529 DOI: 10.21203/rs.3.rs-3062583/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Purpose Inborn errors of the IL-17A/F-responsive pathway lead to chronic mucocutaneous candidiasis (CMC) as a predominant clinical phenotype, without other significant clinical manifestations apart from mucocutaneous staphylococcal diseases. Amongst inborn errors affecting IL-17-dependent immunity, autosomal recessive (AR) IL-17RC deficiency is a rare disease with only three kindreds described to date. The lack of an in vitro functional evaluation system of IL17RC variants renders its diagnosis difficult. We sought to characterize a seven-year-old Japanese girl with CMC carrying a novel homozygous duplication variant of IL17RC and establish a simple in vitro system to evaluate the impact of this variant. Methods Flow cytometry, qPCR, RNA-sequencing, and immunoblotting were conducted, and an IL17RC-knockout cell line was established for functional evaluation. Results The patient presented with oral and mucocutaneous candidiasis without staphylococcal diseases since the age of three months. Genetic analysis showed that the novel duplication variant (Chr3: 9,971,476-9,971,606 dup (+ 131bp)) involving exon 13 of IL17RC results in a premature stop codon (p.D457Afs*16 or p.D457Afs*17). Our functional evaluation system revealed this duplication to be loss-of-function and enabled discrimination between loss-of-function and neutral IL17RC variants. The lack of response to IL-17A by the patient's SV40-immortalized fibroblasts was restored by introducing WT-IL17RC, suggesting that the genotype identified is responsible for her clinical phenotype. Conclusions The clinical and cellular phenotype of the current case of AR IL-17RC deficiency supports a previous report on this rare disorder. Our newly established evaluation system will be useful for diagnosis of AR IL-17RC deficiency, providing accurate validation of unknown IL17RC variants.
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Affiliation(s)
- Kosuke Noma
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Miyuki Tsumura
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Tina Nguyen
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Takaki Asano
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Fumiaki Sakura
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Moe Tamaura
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yusuke Imanaka
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yoko Mizoguchi
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Shuhei Karakawa
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Seiichi Hayakawa
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Takayo Shoji
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Junichi Hosokawa
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Kazushi Izawa
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Yun Ling
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | | | - Anne Puel
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Stuart G Tangye
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Cindy S Ma
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Osamu Ohara
- Hiroshima University Graduate School of Biomedical and Health Sciences
| | - Satoshi Okada
- Hiroshima University Graduate School of Biomedical and Health Sciences
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Paolicelli G, Luca AD, Jose SS, Antonini M, Teloni I, Fric J, Zelante T. Using Lung Organoids to Investigate Epithelial Barrier Complexity and IL-17 Signaling During Respiratory Infection. Front Immunol 2019; 10:323. [PMID: 30873173 PMCID: PMC6403157 DOI: 10.3389/fimmu.2019.00323] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/07/2019] [Indexed: 01/23/2023] Open
Affiliation(s)
| | - Antonella De Luca
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Shyam S Jose
- Center for Translational Medicine, International Clinical Research Centre, St. Anne's University Hospital Brno, Brno, Czechia
| | - Martina Antonini
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Irene Teloni
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - Jan Fric
- Center for Translational Medicine, International Clinical Research Centre, St. Anne's University Hospital Brno, Brno, Czechia
| | - Teresa Zelante
- Center for Translational Medicine, International Clinical Research Centre, St. Anne's University Hospital Brno, Brno, Czechia
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